Medicare Supplement Plans in Massachusetts: Compare and Save Today
How Do Medicare Supplement Plans Work in Massachusetts?
Medicare Supplement Plans, often referred to as Medigap Plans, are designed to help cover healthcare costs not fully paid by Original Medicare, such as deductibles, copayments, and coinsurance. These plans provide valuable financial protection for those seeking to minimize out-of-pocket expenses.
In Massachusetts, Medigap Plans follow a unique standardization model, offering simplified options compared to the lettered plans available in other states. Understanding your choices under Medicare Supplement Plans can help you find the right coverage to meet your healthcare needs.
What Are Medicare Supplement Plan Options in Massachusetts?
In 2025, Massachusetts offers two main Medicare Supplement Plans (Medigap Plans): the Core Plan and Supplement 1A plan. These plans provide essential coverage for costs not fully paid by Original Medicare. The Core Plan covers basic benefits, while Supplement 1A offers more comprehensive protection.
| Benefit | Core Plan | Supplement 1A |
|---|---|---|
| Medicare Part A Coinsurance and Hospital Costs | ||
| Medicare Part B Coinsurance or Copayment | ||
| Blood (First 3 Pints) | ||
| Part A Hospice Care Coinsurance or Copayment | ||
| Skilled Nursing Facility Coinsurance | ||
| Medicare Part A Deductible | ||
| Foreign Travel Emergency | ||
| Note on Supplement 1 Plan: While no longer widely available to new enrollees, Supplement 1 offers the same benefits as Supplement 1A plus coverage for the Medicare Part B deductible. However, it is only available to individuals who became eligible for Medicare before January 1, 2020. | ||
How Are Medicare Supplement Plans in Massachusetts Different from Other States?
The table below highlights the key differences in Medicare Supplement Plans between Massachusetts and other states, including plan options, pricing, and guaranteed issue rights.
| Feature | Massachusetts | Other States |
|---|---|---|
| Plan Options | Core Plan, and Supplement 1 | Standardized plans labeled A through N |
| Premium Pricing | Community-rated (same premium for all enrollees) | Community-rated, Issue-age-rated, or Attained-age-rated |
| Guaranteed Issue Rights | Year-round guaranteed issue rights (no medical underwriting) | Limited to specific periods (e.g., Open Enrollment Period) |
| Additional State-Mandated Benefits | Annual preventive services, extended mental health inpatient coverage | Typically adheres to federal standards with few state variations |
| Foreign Travel Emergency | Included in Supplement 1 and 1A | Included in Plans C, D, F, G, M, and N |
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Explore Medicare Supplement PlansWho Can Qualify for Medigap Plans in Massachusetts?
If you’re a resident of Massachusetts and enrolled in Medicare Part A and Part B, you’re eligible to apply for a Medicare Supplement Plan, also known as a Medigap Plan. These plans are designed to help cover healthcare costs not fully paid by Original Medicare, such as copayments, coinsurance, and deductibles.
To enroll in a Medigap Plan in Massachusetts, you must meet the following eligibility requirements:
1. Medicare Enrollment
You must already be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance).
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View Enrollment Deadlines2. Residency
You must reside in Massachusetts, as plans are standardized differently from those in other states.
3. Age or Disability
- 65 and Older: Most residents qualify for Medigap when they turn 65 and enroll in Medicare Part B.
- Under 65: In Massachusetts, insurers are required to offer at least one Medigap plan (typically the Core Plan) to residents under 65 who are eligible for Medicare due to a disability.
When Can You Enroll in Medigap Plans in Massachusetts?
Residents of Massachusetts have flexible and unique opportunities to enroll in Medicare Supplement Plans (Medigap Plans). Unlike other states, Massachusetts provides year-round enrollment options and special protections that make it easier to buy or switch plans without facing penalties or denials due to pre-existing conditions.
1. Year-Round Enrollment with Guaranteed Issue Rights
In Massachusetts, you can apply for or switch Medigap Plans at any time of the year. Thanks to the state’s guaranteed issue rights:
- No Medical Underwriting: Insurers cannot deny you coverage or charge higher premiums based on your health or pre-existing conditions.
- Flexibility: You can change plans if your needs evolve, giving you the freedom to adjust your coverage whenever necessary.
2. Annual Open Enrollment Period
Massachusetts also offers an annual Medigap Open Enrollment Period from February 1 to March 31, during which you can:
- Enroll in a new Medigap Plan.
- Switch from one Medigap Plan to another.
Coverage changes made during this period take effect on June 1.
3. Special Enrollment Periods (SEPs)
Certain life events may qualify you for a Special Enrollment Period (SEP), allowing you to buy Medigap insurance outside of standard enrollment periods. Examples include:
- Losing other health coverage, such as employer or union-based insurance.
- Moving out of the service area of a Medicare Advantage Plan.
- Returning to Original Medicare from a Medicare Advantage Plan.
During a SEP, you typically have 63 days to enroll in a Medigap Plan with guaranteed issue rights.
4. Initial Enrollment for New Medicare Beneficiaries
If you are turning 65 or are newly eligible for Medicare Part B, your Initial Enrollment Period (IEP) allows you to buy a Medigap Plan without restrictions. This period lasts for six months, beginning the month you are both:
- Enrolled in Medicare Part B.
- Aged 65 or older.
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How Are Medigap Plan Premiums Calculated in Massachusetts?
In Massachusetts, Medicare Supplement Plan (Medigap Plan) premiums are calculated using a community rating system. This means that every enrollee pays the same monthly premium for the same plan, regardless of their age, gender, health condition or tobacco use. Additional benefits or coverage options included by the insurer also influence premiums.
Can You Save Money on Your Medigap Premium in Massachusetts?
Yes, some insurers in Massachusetts may offer discounts on Medigap Plan premiums based on specific situations, such as living arrangements or family enrollment. While discounts are not mandated by law, they can be a valuable way to lower your monthly costs. Here are common types of discounts to look for:
1. Household Discounts
Many insurers offer household discounts if you share a residence with another person who also has a policy with the same insurer, such as spouse discount or roommate discount.
This could apply if:
- You and your spouse or partner are both enrolled in Medigap Plans from the same provider.
- You live with another eligible policyholder, such as a roommate or family member.
Savings Potential:
Typically range from 5% to 12%.
2. Annual Payment Discounts
If you pay your premium annually rather than monthly, some insurers may offer a discount for upfront payments. This helps insurers reduce administrative costs, which they pass on to you in the form of savings.
Savings Potential:
Typically range from 2% to 5%.
3. Early Enrollment Discounts
While not as common, some insurers may offer discounts for enrolling early, such as during your Initial Enrollment Period or within a specific timeframe.
Savings Potential:
Typically up to 5%.
4. Electronic Payment Discounts
Using automatic bank withdrawals (Electronic Funds Transfer or EFT) to pay your premium can also earn you a small discount. This reduces administrative hassle for insurers and ensures timely payments.
Savings Potential:
Small, around $2 - $5 per month, but add up over time
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Discover Local Assistance OptionsHow Can You Find Discounts?
To ensure you’re getting all eligible discounts, work with a trusted insurance agent. At Hesteon, we can help you identify insurers offering the best discounts and savings programs.
We're here to help you explore available discounts.
Medigap vs. Medicare Advantage in Massachusetts: Which Is Right for You?
Choosing between Medigap Plans and Medicare Advantage Plans in Massachusetts depends on your healthcare needs, preferences, and lifestyle. Here’s a comparison to help you decide:
| Feature | Medigap Plans | Medicare Advantage Plans |
|---|---|---|
| Coverage and Flexibility |
|
|
| Costs |
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|
| Prescription Drug Coverage |
|
|
| Eligibility and Enrollment |
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If you prefer broader provider access and predictable costs, Medigap might be the better choice. If additional benefits and lower premiums fit your budget, Medicare Advantage could work for you.
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Explore Medicare AdvantageWhich Medigap Plan Should You Choose in Massachusetts?
Massachusetts offers two primary Medigap Plans: The Core Plan and Supplement 1A. Choosing the right plan depends on your budget and healthcare needs.
1. Core Plan
Best for: Those seeking affordable, basic coverage. The Core Plan covers:
- Medicare Part A and Part B coinsurance.
- The first three pints of blood annually.
- Part A hospice care coinsurance.
What's Missing: It does not cover the Medicare Part A deductible, skilled nursing facility coinsurance, or foreign travel emergencies.
2. Supplement 1A
Best for: Those wanting broader coverage. Supplement 1A includes everything in the Core Plan, plus:
- Coverage for the Medicare Part A deductible.
- Skilled nursing facility coinsurance.
- Emergency care during foreign travel.
What's Missing: Supplement 1A does not cover the Medicare Part B deductible.
Note: Supplement 1 Plan offers all the benefits of Supplement 1A plus the Medicare Part B deductible. However, it is only available to those eligible for Medicare before January 1, 2020.
How to Decide?
- Budget: Assess how much you can afford for monthly premiums.
- Healthcare Needs: Consider how often you visit doctors or specialists and whether you need additional benefits like foreign travel coverage.
How Can Hesteon Help You With Medigap Plans in Massachusetts?
At Hesteon, we’ll help you compare options and choose the best plan for your needs. Contact us today for personalized assistance and secure peace of mind with the right Medigap Plan.
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